Mesalamine (5-ASA) Induced Myocarditis: A Case Report

¹Division of Cardiology, Department of Internal Medicine, Clara Maass Medical Center, Robert Wood Johnson University, Barnabas Health System (RWJBH), USA

²Department of Cardiology, Clara Maass Medical Centre, Belleville, New Jersey, USA

*Corresponding author: Sameer Kaul, Department of Cardiology, Clara Maass Medical Centre, Belleville, New Jersey, USA, Tel: 9734502000, E-mails: [email protected]; [email protected]

Received Date: May 13, 2025

Publication Date: May 30, 2025

Citation: Kaul A, et al. (2025). Mesalamine (5-ASA) Induced Myocarditis: A Case Report. Cases. 4(2):22.

Copyright: Kaul A, et al. © (2025).

ABSTRACT

Myocarditis is a rare complication linked to Mesalamine therapy, a medication commonly prescribed for treating inflammatory bowel disease. Mesalamine-induced myocarditis may be more prevalent than previously believed. This case is an important example of why physicians must be aware of Mesalamine treatment, a relatively common first-line drug for patients with Inflammatory bowel diseases. The cardiac side effects of this drug can present as Myocarditis and can lead to significant morbidity if not identified early. Stopping the drug and early treatment can result in good outcomes, as in the given case. A 51-year-old male who was diagnosed with ulcerative colitis developed myocarditis 21 days after the initiation of mesalamine therapy. He presented to the emergency room with difficulty breathing. Labs revealed elevated high-sensitivity Troponins. An echocardiogram showed reduced Left Ventricular function.  The echo revealed moderate to severe global hypokinesis of the left ventricle. Subsequent urgent cardiac catheterization revealed normal right and left Coronaries with no obstruction.  Normal coronaries in the setting significantly elevated Troponins led to the diagnosis of myocarditis. After stopping mesalamine, the patient's symptoms and left ventricular function improved rapidly, and he recovered fully.

Categories: Cardiology, Gastroenterology, Emergency Medicine.

Keywords: Mesalamine, Myocarditis, Ulcerative Colitis.